Best Practices Recommendations:
A Providers Introduction to Substance Abuse Treatment for Gay, Lesbian, Bisexual, and Transgender Individuals
Substance Abuse and Mental Health Services Administration (SAMHSA)Report generated by a consortium of clinicians, researchers, program and administrative managers, policymakers, and practitioners brought together to review and discuss best-practice strategies for treating gay, lesbian, bisexual, and transgender people with substance abuse issues.
This study explores the nature of intentional family relationships between friends of different genders and different sexual orientations. Drawing on in-depth interviews with 46 members of 23 friendship dyads, I first make the case that the friends considered one another family and I specify the criteria they use for making such designations. I then focus on the ways in which gender and sexual orientation influenced relationships between lesbians and straight men and between gay men and straight women. The data provided evidence that the dyad members identified one another as family and served the functions of family for each other. The findings also suggest that various gender issues affect cross-gender, different sexual orientation relationships. Exploring the meaning and functioning of these intentional family ties documents their existence and illuminates their meaning and maintenance.
Perceptual and decisional processing of diagnostic and non-diagnostic cues of women’s sexual interest: Influence of alcohol intoxication and sexual coercion history
Abstract: Young men’s errors in sexual perception have been linked to sexual coercion. The current investigation sought to further explicate (a) the perceptual and decisional sources of these social perception errors and their link to risk for sexual violence, and (b) the influence of alcohol intoxication on sexual perception. General Recognition Theory (Ashby & Townsend, 1986) was used to estimate participants’ ability to discriminate between affective cues and clothing style cues and to measure illusory correlations between men’s perception of women’s clothing style and sexual interest. Men at high risk for perpetrating sexual coercion were less sensitive to the distinction between women’s friendly and sexual interest cues relative to other men. In addition they were more likely to perceive an illusory correlation between women’s diagnostic sexual interest cues (e.g., facial affect) and non-diagnostic cues (e.g., provocative clothing), which increases the probability that they will misperceive friendly women as intending to communicate sexual interest. Alcohol intoxication decreased men’s ability to discriminate between women’s friendly and sexual interest cues relative to their own performance sober and changed decisional thresholds such that ambiguous positive affect cues were more likely to be perceived as indicative of sexual interest. Nonetheless, participants were equally skilled in discriminating provocative clothing from conservative clothing whether performing intoxicated or sober. The results provide information about the degree of risk conferred by individual differences in perceptual processing of women’s interest cues and the influence of acute alcohol intoxication on sexual perception. It also provide a concrete example for translational scientists interested in adapting GRT in order to be mathematically explicit about predicted individual differences in social perception.
PURPOSE: This paper examines the experience of posttraumatic stress disorder (PTSD) in a female veteran of Operation Iraqi Freedom, including the barriers to treatment she encountered in an outpatient psychiatry clinic. DESIGN AND METHODS. Case report data were obtained through review of records and interviews with a veteran combat nurse diagnosed with chronic PTSD. CONCLUSIONS. Sex differences in PTSD are controversial, but PTSD in female military veterans is a significant problem. Gender may complicate diagnosis and treatment. This case report discusses these issues and invites further research. PRACTICE IMPLICATIONS. Advanced practice psychiatric nurses increasingly will see female veterans with PTSD in their practices.
Links to Resources:
The Gay and Lesbian Medical Association (GLMA).
Studies show that lesbian, gay, bisexual, and transgender populations, in addition to having the same basic health needs as the general population, experience health disparities and barriers related to sexual orientation and/or gender identity or expression. Many avoid or delay care or receive inappropriate or inferior care because of perceived or real homophobia, biphobia, transphobia, and discrimination by health care providers and institutions. There are some simple ways to make your practice environment more welcoming and safe for your LGBT patients. Here are a few ideas to update your physical environment, add or change intake and health history form questions, improve provider-patient discussions, and increase staff’s knowledge about and sensitivity to your LGBT patients.
Judith B. Bradford, PhD; Sean Cahill, PhD; Chris Grasso, MPH; and Harvey J. Makadon, MD
One of the first steps to providing culturally competent care is amending all patient-history and intake forms to assure that they are LGBT-inclusive. In this brief, we discuss two methods for gathering sexual orientation and gender identity from patients, by asking questions on the patient registration (intake) form, and by requiring that providers gather this information directly from patients during medical visits, recording responses in the electronic medical record.
Inclusive Questions for Older Adults: A Practical Guide to Collecting Data on Sexual Orientation and Gender Identity
National Resource Center on LGBT Aging, March 2013
This guide helps to answers the question: “How can our mainstream aging organization ask questions about sexual orientation and gender identity in safe and respectful ways to better inform our services and programs?” Written with suggestions, tips and practical ideas this guide will assist in your organization’s path to asking fully inclusive questions to all of your clients.
The Aging and Health Report: Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults, November 2011
Karen I. Fredriksen-Goldsen, PhD, Hyun-Jun Kim, PhD, Charles A. Emlet, PhD, Anna Muraco, PhD, Elena A. Erosheva, PhD, Charles P. Hoy-Ellis, MSW, Jayn Goldsen, BS, Heidi Petry, P
This publication is the first national federally-funded project to examine LGBT aging and health. It documents significant health disparities impacting LGBT older adults as they age, including disability, physical and mental distress, victimization, discrimination, and lack of access to supportive aging and health services.
Health Equity & LGBT Elders of Color, Services and Advocacy for GLBT Elders (SAGE), April 2013
This brief explores 10 policy areas where health and wellness can be improved for LGBT older people of color (a population that encompasses multiple groups diverse across race, ethnicity, culture, language of origin and more), examining policy topics such as federal funding gaps, the ways in which health reform implementation can reach marginalized people, LGBT-specific barriers within programs such as Social Security, and much more.
National Center for Transgender Equality, August 2011
Medicare is one of America’s most important health programs, providing health insurance for millions of older adults and people with disabilities. As with private insurance, transgender people sometimes encounter limitations in their Medicare coverage or confusion about what is covered – both for transition-related care and for routine preventive care. This document provides an overview of benefit questions that may arise for transgender people, and information on what to do in response to an initial denial of coverage.
Still Serving in Silence: Transgender Service Members and Veterans in the National Transgender Discrimination Survey
Jack Harrison-Quintana and Jody L. Herman
On September 20, 2011, the repeal of “Don’t Ask, Don’t Tell” (DADT) went into effect in the U.S. military. The repeal marked the end of discriminatory practices in the military based on sexual orientation, but it did not end the prohibition on transgender military service. The National Transgender Discrimination Survey (NTDS) found that transgender Americans serve in the military at a high rate; 20 percent of NTDS respondents had served in the armed forces as compared to 10 percent of the U.S. general population. This study draws upon both quantitative and qualitative data about transgender soldiers and veterans who responded to the NTDS to describe who these transgender soldiers and veterans are and what their experiences have been in regard to their military service. This study outlines respondents’ reported issues in obtaining corrected identity documents, accessing military health care, and experiences of discrimination. This study finds that transgender veterans experience substantial barriers in these areas and also experience high rates of family rejection and homelessness.
National Center for Transgender Equality, August 2012
For the first time, the Affordable Care Act of 2010 banned sex discrimination in many health care facilities and programs. While we still desperately need national laws that explicitly prohibit discrimination based on gender identity and sexual orientation, existing laws such as the Affordable Care Act can provide real protections in many circumstances. This document outlines the health care rights of transgender people and how to file complaints of health care discrimination.
November 2012. Mark Brennan-Ing PhD, Stephen E. Karpiak PhD, and Liz Seidel MSW, AIDS Community Research Initiative of America (ACRIA)
This research study provides one of the most comprehensive descriptions of the health, well-being and social context of LGBT older adults. These data should be used to facilitate policy-making and program decisions to address the current and future needs of these individuals.